Par­a­noia af­flicts as many as one in three peo­ple, re­search­ers have con­clud­ed based on a study us­ing vir­tu­al real­ity.

Sci­en­tists have had trou­ble stu­dying par­a­noia, or ex­ag­ger­at­ed fear of threats from oth­er peo­ple, in con­trolled lab­o­r­a­to­ry set­tings. Re­search­ers have of­ten set­tled in­stead for giv­ing out ques­tion­naires, which can be in­ac­cu­rate.

The new in­ves­ti­ga­t­ion sought to solve the prob­lem by put­ting vol­un­teers through a vir­tu­al sub­way or un­der­ground
ride to gauge par­a­noid ten­den­cies.

“Para­noid thoughts are of­ten trig­gered by am­big­u­ous events such as peo­ple look­ing in one’s di­rec­tion or hear­ing laugh­ter in a room, but it is very dif­fi­cult to rec­re­ate such so­cial in­ter­ac­tions,” said Dan­iel Free­man of King’s Col­lege Lon­don, who led the study.

“Vir­tual real­ity al­lows us to do just that, to look at how dif­fer­ent peo­ple in­ter­pret ex­actly the same so­cial situa­t­ion.”

Wear­ing head­sets to be im­mersed in the vir­tu­al en­vi­ron­ment, 200 vol­un­teers cho­sen to be broadly rep­re­sent­a­tive of the gen­er­al popula­t­ion walked around a vir­tu­al Lon­don un­der­ground car in a four-minute trip be­tween sta­t­ion stops.

The car­riage con­tained what the re­search­ers said were neu­tral com­put­er peo­ple, called av­a­tars, that breathed, looked around, and some­times met the gaze of the par­ti­ci­pants. One av­a­tar read a news­pa­per, anoth­er would oc­ca­sion­ally smile if looked at. A sound­track of a train car­riage was played.

Free­man and col­leagues found that the par­ti­ci­pants in­ter­preted the same com­put­er char­ac­ters very dif­fer­ently. The most com­mon re­ac­tion was to find the vir­tu­al real­ity char­ac­ters friendly or neu­tral, but al­most 40 per­cent of the par­ti­ci­pants ex­pe­ri­enced at least one par­a­noid thought, said Free­man.

The in­ves­ti­ga­tors as­sessed par­ti­ci­pants be­fore the “ride,” and found that those who were anx­ious, wor­ried, fo­cused on the worst-case sce­nar­i­os and had low self-es­teem were most likely get par­a­noid. The re­sults of the study are pub­lished March 31 in the
Brit­ish Jour­nal of Psy­chi­a­try.

Com­ments about the vir­tu­al real­ity char­ac­ters by par­ti­ci­pants who ex­pe­ri­enced par­a­noid thoughts in­clud­ed:

“There was a guy spook­ing me out – tried to get away from him. Did­n’t like his face. I’m sure he looked at me more than a cou­ple of times though might be im­ag­in­ing it.”

“A girl kept mov­ing her hand. Looked like she was a pick­pock­et and would pass it to the per­son stand­ing op­po­site her.”

“Felt trapped be­tween two men in the door­way. As a wom­an I’m a lot more sus­pi­cious of men. Did­n’t like the close proxim­ity of the men. The guy op­po­site may have had sex­u­al in­tent, ma­nipula­t­ion or what­ev­er.”

“There’s some­thing dodgy about one guy. Like he was about to do some­thing – as­sault some­one, plant a bom­b, say some­thing not nice to me, be ag­gres­sive.”

“In the past, only those with a se­vere men­tal ill­ness were thought to ex­pe­ri­ence par­a­noid thoughts, but now we know that this is simply not the case,” said Free­man. “About one-third of the gen­er­al popula­t­ion reg­u­larly ex­pe­ri­ence
per­se­cu­to­ry thoughts. This should­n’t be sur­pris­ing. At the heart of all so­cial in­ter­ac­tions is a vi­tal judg­ment wheth­er to trust or mis­trust, but it is a judg­ment that is error-prone. We are more likely to make par­a­noid er­rors if we are anx­ious, ru­mi­nate and have had bad ex­pe­ri­ences from oth­ers.”

Free­man said par­a­noid thoughts are more likely to de­vel­op in set­tings such as on pub­lic trans­port, where peo­ple can feel trapped and
watched, and can’t hear what oth­ers are say­ing. Peo­ple who feared ter­ror­ism un­der­ground tended to re­port more par­a­noid thoughts in the vir­tu­al train, pos­sibly re­flect­ing the after-effects of the Lon­don bom­bings on July 7, 2005, he added. But the re­search­ers al­so found that peo­ple who reg­u­larly used the Un­der­ground ex­pe­ri­enced few­er par­a­noid thoughts in the vir­tu­al train.

“Para­noid think­ing is a top­ic of na­tional dis­cus­sion giv­en in­creas­ing pub­lic at­ten­tion to threats such as ter­ror­ism,” said Free­man. “It some­times seems as if the one thing that un­ites the di­verse peo­ples of the world is our fear of one anoth­er. Wor­ries about oth­er peo­ple are so com­mon that they seem to be an es­sen­tial – if un­wel­come – part of what it means to be hu­man.”

Par­a­noia is in­creas­ingly be­ing treated us­ing a tech­nique known as cog­ni­tive be­hav­iour­al ther­a­py. In the fu­ture, vir­tu­al real­ity may be­come a tool in clin­i­cal as­sess­ment and be in­cor­po­rat­ed in­to these treat­ments, Free­man said, al­low­ing pa­tients to test out their fears in vir­tu­al worlds.

Paranoia afflicts as many as one in three people, researchers have concluded based on a study using virtual reality.
Scientists have had trouble studying paranoia, or exaggerated fear of threats from other people, in controlled laboratory settings. Researchers have often settled instead for giving out questionnaires, which can be inaccurate.
The new investigation sought to solve the problem by putting volunteers through a virtual subway or underground ride, in order to probe their paranoid tendencies.
“Paranoid thoughts are often triggered by ambiguous events such as people looking in one’s direction or hearing laughter in a room, but it is very difficult to recreate such social interactions,” said Daniel Freeman of King’s College London, who led the study. “Virtual reality allows us to do just that, to look at how different people interpret exactly the same social situation.”
Wearing headsets to be immersed in the virtual environment, 200 volunteers chosen to be broadly representative of the general population walked around a virtual London underground car in a four-minute trip between station stops.
The carriage contained what the researchers said were neutral computer people, called avatars, that breathed, looked around, and sometimes met the gaze of the participants. One avatar read a newspaper, another would occasionally smile if looked at. A soundtrack of a train carriage was played.
Freeman and colleagues found that the participants interpreted the same computer characters very differently. The most common reaction was to find the virtual reality characters friendly or neutral, but almost 40% of the participants experienced at least one paranoid thought, said Freeman.
The investigators assessed participants before the “ride,” and found that those who were anxious, worried, focused on the worst-case scenarios and had low self-esteem were most likely get paranoid. The results of the study are published March 31 in the British Journal of Psychiatry.
Comments about the virtual reality characters by participants who experienced paranoid thoughts included:
“There was a guy spooking me out – tried to get away from him. Didn’t like his face. I’m sure he looked at me more than a couple of times though might be imagining it.”
“A girl kept moving her hand. Looked like she was a pickpocket and would pass it to the person standing opposite her.”
“Felt trapped between two men in the doorway. As a woman I’m a lot more suspicious of men. Didn’t like the close proximity of the men. The guy opposite may have had sexual intent, manipulation or whatever.”
“There’s something dodgy about one guy. Like he was about to do something – assault someone, plant a bomb, say something not nice to me, be aggressive.”
“In the past, only those with a severe mental illness were thought to experience paranoid thoughts, but now we know that this is simply not the case,” said Freeman. “About one-third of the general population regularly experience persecutory thoughts. This shouldn’t be surprising. At the heart of all social interactions is a vital judgment whether to trust or mistrust, but it is a judgment that is error-prone. We are more likely to make paranoid errors if we are anxious, ruminate and have had bad experiences from others.”
Freeman said paranoid thoughts are more likely to develop in settings such as on public transport, where people can feel trapped and observed, and can’t hear what others are saying. People who feared terrorism underground tended to report more paranoid thoughts in the virtual train, possibly reflecting the after-effects of the London bombings on July 7, 2005, he added. But the researchers also found that people who regularly used the Underground experienced fewer paranoid thoughts in the virtual train.
“Paranoid thinking is a topic of national discussion given increasing public attention to threats such as terrorism,” said Freeman. “It sometimes seems as if the one thing that unites the diverse peoples of the world is our fear of one another. Worries about other people are so common that they seem to be an essential – if unwelcome – part of what it means to be human.”
Paranoia is increasingly being treated using a technique known as cognitive behavioural therapy. In the future, virtual reality may be used as a tool in clinical assessment and be incorporated into these treatments, Freeman said, allowing patients to test out their fears in virtual worlds.